Category Archives: Smoking Cessation

Bigger wine glasses make us drink too much, says researcher

Wine glasses have increased in size from a capacity of 65ml 300 years ago to 450ml today and the change has encouraged us to drink far more than we should, according to a behavioural scientist speaking at the Hay festival.

Theresa Marteau, director of the behaviour and health research unit at Cambridge University, said her team had looked at 18th-century wine glasses at the Ashmolean museum in Oxford, 19th-century wine glasses owned by Buckingham Palace, and more recent glasses in John Lewis catalogues and the evidence was clear: they had got bigger.

“There has been a gradual increase in capacity from 65ml to 450ml,” she told Hay festival. “The key period was the 1990s.” Size matters because the bigger the glass the more we are inclined to consume, she said.

Her team carried out a six-week experiment in a Cambridge wine bar where 175ml of wine was sold in three different sized glasses at different times. Sales in the biggest glasses rose 14%, with no difference in the other two.

Plates and dishes are also getting bigger, which may be one of the reasons 65% of the UK population is overweight or obese.

Marteau described an experiment where two sets of people sat at a dinner table eating soup. One couple had a bottomless soup bowl that was gradually filled up from below while the others had a standard bowl. The first couple ate twice as much but felt as full as the ones who ate from the normal soup bowl.

Smaller plates and dishes would have an effect on public health, Marteau said. “If we made sizes smaller for all food tableware, for every occasion we encounter food the effects of size would be to reduce how much we consume by up to 16% in adults per day.”

Marteau’s team looks at why information about the risks of smoking, drinking, eating and not doing enough exercise does not seem to change our unhealthy behaviour.

Sometimes it was as simple as the message, she said. A warning that the ice is thin and you may die is more offputting than a message that the sofa you are sitting on could be a killer.

Our environment also has a strong influence on behaviour, whether that is how safe streets are to go for walks on, or how big the products are with a slice of white bread increasing in size by 11% in 20 years in the UK.

Marteau said she was not at Hay plugging a book; all of the research carried out by her team is available free online. But she is keen to do more research into British drinking habits. “I should say anyone who has control of large bars such as Wetherspoons, we would love to collaborate with you.”

This is what the blood donor service does after an attack – and how you can help | Jane Green

I was overwhelmed by how generously the people of Manchester responded to this horrific attack. Both our blood donor centres in Manchester had queues outside the doors before they even opened. Our national call centre was taking about 1,000 calls an hour by 10am, from people who wanted to help save lives by donating blood.

The response was driven by well-intentioned social media posts from the public. The desire to help was incredible. However we already had enough blood to supply the hospitals treating the victims, and we did not appeal for extra donors. We plan ahead to build in reserves to deal with major incidents. We hope that people who want to help will now become regular donors, because that is how they can best help us save lives when there is a tragedy.

Many people wanted to donate to help that day, but when you donate blood, it is not taken straight to a patient. We need time to test it and process it. The different components such as platelets and red blood cells need to be separated out. Typically, your blood donation will only reach a patient two or three weeks after you donate. The blood used to treat the Manchester victims would have been donated several weeks earlier, and those donors would have been from across the country.

Hospitals order blood from us in advance, without the need for blood to be brought in for each patient. We supply hospitals through our regional stock-holding units (what people refer to as “blood banks”) mainly through routine deliveries. Over Monday night we made 21 deliveries of blood to hospitals in Manchester, including 15 “blue light” emergency deliveries, delivering 346 units of red blood cells. We were able to meet all the hospitals’ requests, and our stocks remained good. We don’t know exactly how this blood was used, and much of the blood from the routine deliveries would have gone to patients not affected by the attack. But this was an exceptionally high level of local emergency demand and many of those precious donations would have been transfused into attack victims.

Trauma patients require more than just red blood cells. They also need platelets to help their blood clot, and other more specialised products: O-negative blood is especially important in emergencies because it can be given to anyone when time is short and you don’t have time to test for blood groups. We always need new O-negative donors because their blood is so valuable.

As Tuesday morning progressed, people began queueing to donate. Some had friends or family members caught up in the incident. We were worried they might be confused or upset about why there was no capacity or urgent need for them to donate that day.

We were inspired to see the diversity of people coming forward, because we need more black and Asian donors

We tried to spread the message about how people could best help across social media and through the press. I was working at Plymouth Grove donor centre, next to Manchester Royal Infirmary, where many victims were being treated, and I spoke to many people face to face. We were inspired to see the diversity of people coming forward, which was moving and very important – because we need more black and Asian donors. Patients benefit from closely matched blood, which will often come from donors of the same ethnicity.

Our message is that blood can best save lives in a tragedy when our stocks are already good through regular donations. Thanks to our loyal army of nearly 900,000 active donors, many of whom give blood three or four times a year, we can do that. But every year many of these donors have to drop out because of age, ill health and many other reasons. We need nearly 200,000 people to register as new donors every year.

If people have been inspired to donate for the first time, please go online, make an appointment, and donate. Blood saves lives, and your donation will help other people in urgent need, and make sure we are again ready for any major incident.

NHS faces staggering increase in cost of elderly care, academics warn

The NHS and social care system in the UK is facing a staggering increase in the cost of looking after elderly people within the next few years, according to major new research which shows a 25% increase in those who will need care between 2015 and 2025.

Within eight years, there will be 2.8 million people over 65 needing nursing and social care, unable to cope alone, says the research – largely because of the toll of dementia in a growing elderly population. The research, published by the respected Lancet Public Health medical journal, says cases of disability related to dementia will rise by 40% among people aged 65 to 84, with other forms of disability increasing by about 31%.

The new figures follow a furore over the Conservative manifesto and Theresa May’s U-turn on social care this week. In a bid to keep the costs of care down, the manifesto said those needing care at home would have to pay until they had £100,000 in savings left, including the cost of their home.

After accusations that the Conservatives were imposing a “dementia tax”, May promised a cap on the amount any person would pay for care – although without specifying what the cap would be.

The new analysis will make grim reading for whichever party gains power. “The societal, economic and public health implications of our forecast are substantial,” say the researchers, led by academics from the University of Liverpool and University College London.

“Public and private expenditure on long-term care will need to increase considerably by 2025, in view of the predicted 25% rise in the number of people who will have age-related disability. This situation has serious implications for a cash-strapped and overburdened National Health Service and an under-resourced social care system,” they added.

The figures take account for the first time of the changing disease burden as well as the increasing elderly population and longer life expectancy. Cardiovascular disease, which can cause heart attacks and strokes, has gone down, but dementia is rising as people live longer. This makes the research an advance on previous studies, says Professor Stuart Gilmour of the department of global health policy at the University of Tokyo in a commentary published alongside the paper.

“The results show starkly the growing burden of disability that the UK National Health Service and social care system will face over the next decade,” he writes.

“[It] faces a rapid increase in the number of elderly people with disabilities … at a time when it is uniquely unprepared for even the existing burden of disability in the UK population. This important research should be taken as a warning and a strong call for action on health service planning and funding, workforce training and retention, and preparation for the ageing of British society.”

The government urgently needs to consider the options, says the paper. Firstly, more care homes are needed, it says. Secondly, there must be more support for informal and home care – they suggest tax allowances or cash benefits. “Affected individuals and their families pay an estimated 40% of the national cost of long-term care from income and savings,” they write.

But prevention is also vital. Poor diet, smoking, drinking heavily, high blood pressure, diabetes and little physical activity are risk factors for both heart disease and dementia, they say. Immediate investment in improving people’s lifestyles would pay dividends, they say. “We seriously need to protect the future of older citizens through prevention,” said lead author Dr Maria Guzman-Castillo of the University of Liverpool.

She said political parties had not so far been looking at the true scale of the crisis to come. “We think they are not looking at this. There is a gap between the academic community and the government,” she said.

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said more investment in the NHS and social care was desperately needed. “It’s a great testament to medical research, and the NHS, that we are living longer – but we need to ensure that our patients are living longer with a good quality of life. For this to happen we need a properly funded, properly staffed health and social care sector with general practice, hospitals and social care all working together – and all communicating well with each other, in the best interests of delivering safe care to all our patients.”

Margaret Willcox, president of the Association of Directors of Adult Social Services (ADASS), said: “As most people expect to need some form of care in their lifetime, there is an urgent need for the whole country to consider how best to ensure people with care needs are funded and how their care is delivered.

“The need to future-proof adult social care should be a national priority for the new government. Unless a long-term sustainable solution is established to tackle significant sector pressures, a rising number of elderly and disabled people living longer and with increasingly complex needs, along with their families, will struggle to receive the personal, dignified care they depend on and deserve.”

Conservatives buy ‘dementia tax’ Google ad as criticism of policy grows

The Conservatives have paid for a Google advert that appears at the top of the page when users search for “dementia tax” in response to growing attacks on Theresa May’s social care policy.

People using the search engine on Monday to find out about the term, coined to describe the prime minister’s manifesto commitment to shake up the funding of old age care, found the top result was a paid-for link from that read: “The so-called ‘dementia tax’ – get the real facts.”

It links to a five-point Q&A, which explains that “only by getting a good Brexit deal will we be able to continue to fund our public services, like social care”. The tactic shows the Conservatives are willing to adopt the pejorative term for their policy, in the digital realm at least, in order to fight back against criticism.

It comes after the Financial Times used the phrase on its front page on Monday in a report that claimed senior Tories were not briefed on its inclusion in last week’s manifesto. May has said she would make elderly people pay for care in their own home unless they have less than £100,000 in assets.

The battle for influence over the information voters receive online was illustrated further when Labour appeared to counter the Conservative move by also buying an advertised link at the top of Google searches for the term.

The paid for Labour link read: “The Conservative manifesto – what You need to know.”

Access to the top of Google’s rankings is available to be bought, with the price set through digital auctions. Digital campaigning experts said the total cost was likely to be hundreds of pounds although the exact amount depends on the number of people that click through. According to Google data, interest in the term “dementia tax” rose steadily throughout Monday morning.

May is coming under pressure to drop or water down her controversial shakeup of social care amid warnings that it is unfair and could deter older people from seeking care.

Conservative candidates are reporting that the proposal is going down badly on the doorstep, potentially accounting for a drop in the party’s lead in the polls. Two Tory candidates seeking re-election, including Sarah Wollaston, who chaired the Commons health committee, have gone on the record to criticise the proposal.

Senior Tories including Boris Johnson and Damian Green were sent out to defend the policy on Sunday as “grownup and responsible”, but reports have emerged that the shakeup was inserted in the manifesto at the last minute without the approval of some cabinet ministers.

With the policy polling badly, opposition parties lined up to condemn May’s decision. Labour said it was in effect a “dementia tax”, hitting those unlucky enough to become ill in old age.

Marlboro maker accused of using branded tins to sidestep plain packaging rules

The maker of Marlboro cigarettes has been accused of trying to sidestep new UK laws on plain packaging by rolling out durable tins that look just like ordinary cigarette packets.

Philip Morris, one of the world’s largest tobacco companies, came under fire from MPs and anti-smoking campaigners on the eve of the biggest change in tobacco regulation since the smoking ban.

From Saturday, retailers will no longer be able to sell branded cigarette packets, as a 12-month grace period to allow tobacco firms to phase out old cartons comes to an end.

Instead, retailers will only stock plain packets featuring graphic pictures designed to deter smokers. They will also no longer be allowed to stock packets of 10 cigarettes or smaller sizes of rolling tobacco, as part of a package of measures designed to limit the appeal of smoking.

In the run-up to the change, Philip Morris has distributed tin containers, the same size as a 10-pack of cigarettes, to convenience stores around the country. The tins, which were available at chains including Sainsbury’s, Londis and Budgens, are printed with Marlboro branding, and feature deterrent pictures and the message “Smoking kills”.

One expert said focusing on smaller packs could impact specific groups. “Research shows that packs of 10 appeal to young people and the price conscious,” said Karen Reeves-Evans, of the Tobacco Control Research Group at the University of Bath.

“By offering packs of 10 in reusable tins, Philip Morris International is knowingly increasing the lifespan of packs of 10 and promoting its brand, if smokers decant their cigarettes into these small branded tins. The fact that these tins appeared almost immediately prior to the branding and size restrictions coming into force is suspicious.”

Alex Cunningham, the Labour MP for Stockton North and a vocal campaigner for plain packaging, said the move appeared to be a ploy to prolong the visibility of Marlboro’s brand in the UK.

“It’s against the whole spirit of what’s intended with the plain packaging legislation,” he said. “The tobacco companies will stop at nothing in order to retain their branding and sell a product that everyone knows has such tremendous health risks. It’s an immature trick and I hope people will soon put them into their bins and they’ll find their way to the recycling centre.”

The chief executive of Action on Smoking and Health, Deborah Arnott, said the metal tins appeared to contradict the company’s recent declaration that it was aiming for a “smoke-free future”. She said: “What’s important is not what they say but what they do.”

Under the EU directive, all tobacco packaging will be uniformly green with large images showing the harmful effects of smoking

Warning labels on boxes of cigarettes in a newsagent in London. Photograph: Bloomberg via Getty

Philip Morris said it manufactured the tins before 20 May last year, the cutoff point after which tobacco firms were no longer allowed to produce branded packs. But the legislation gave firms a 12-month grace period to continue distribution, allowing the firm to keep selling them.

It said only a “relatively small number” were distributed, although it would not say how many, adding that the stocks would be depleted by the weekend deadline.

The tins cost the same as an ordinary pack of 10 cigarettes but, unlike cardboard packets, could help keep Marlboro’s branding visible for years because they are so durable. A thread on Reddit, the messageboard website, suggests the tins havehelped increase the popularity of Marlboro, with users saying they were making an effort to find them.

The Guardian understands that some retailers were offered the product but refused to stock it. Philip Morris rival JTI Gallaher has also issued aluminium tins for its Benson & Hedges, Mayfair and Camel brands in the run-up to the plain packaging laws coming into force in the Republic of Ireland.

The move was described as “extremely cynical” by Ireland’s former health minister James Reilly, according to the Sunday Times. A spokesperson for British American Tobacco, which owns brands including Rothmans and Dunhill, said the company had not issued a similar product.

The tobacco industry has previously come under fire for allegedly deploying tactics designed to limit the effect of plain packaging legislation, such as using price stickers to differentiate themselves from other brands.

Companies were also accused of ramping up production of branded packaging in the days leading up to 20 May last year, in order to stockpile packets for sale during the 12-month grace period in which their sale was still permitted.

Big tobacco firms have failed in successive attempts to overturn countries’ laws on plain packaging. Philip Morris lost a landmark case against the government of Uruguay, while an attempt to overturn Australia’s plain packaging law via a World Trade Organisation dispute also failed.

General election 2017: ITV hosts first leaders’ debate – politics live


ITV debate – Severin Carrell’s analysis

The ITV leaders debate has exposed the patchwork, oddly shaped nature of the UK’s political system. The only two party leaders with a realistic chance of becoming prime minister, Theresa May and Jeremy Corbyn, have declined to appear – further highlighting the weakness of this format, in which the speakers spent much of the debate virtue-signalling, untested.

We had leaders of two nationalist parties whose candidates only stand in small parts of the UK, in Nicola Sturgeon of the Scottish National party, and Leanne Wood from the Welsh nationalists Plaid Cymru. Yet neither are candidates in the election. Tim Fallon of the Liberal Democrats, Caroline Lucas of the English Greens and Paul Nuttall of Ukip are standing, yet none has a realistic chance of being in the next government. The Greens will likely end with one MP, in Lucas. Ukip are likely to end with none at all.

Only Nuttall, the one outsider among the five, was directly challenged over his policies. Nicola Sturgeon, Scotland’s first minister, is the only one of the five who has served in government. Yet her 10 years in power in Edinburgh was not under direct scrutiny in this debate, facing an audience in Salford that can never vote for her. Likewise Wood.

Sturgeon made assertions on Scotland’s economy for which there is no evidence, implying that the SNP’s policy of lifting 100,000 small businesses out of paying business rates has helped the economy. The Scottish government has never tested the benefits of that policy for the Scottish economy, which is on the cusp of official recession.

The SNP (@theSNP)

FM: “Growing the economy means doing more to support business, in Scotland we’re taking 100000 businesses out of business rates.” #ITVDebate

May 18, 2017

Clearly aware of this, Sturgeon had the insight to qualify her own answers – confirming how odd this debate really was. Keenly aware that her government’s patchy record on education is a fierce topic of debate in Scotland, she said: “Nothing is more important to me than education, where there are some challenges we are working really hard to address.”

Unprovoked, she said the same about housing: “We’ve got challenges; we’ve not done everything right.” It is quite unclear what meaningful impact this programme will have on the final outcome of the election on 8 June.



ITV debate – Verdict from the Twitter commentariat

General election 2017: ITV hosts first leaders’ debate – politics live


Question 2 – NHS and social care











Air pollution kills more people in the UK than in Sweden, US and Mexico

People in the UK are 64 times as likely to die of air pollution as those in Sweden and twice as likely as those in the US, figures from the World Health Organisation reveal.

Britain, which has a mortality rate for air pollution of 25.7 for every 100,000 people, was also beaten by Brazil and Mexico – and it trailed far behind Sweden, the cleanest nation in the EU, with a rate of 0.4.

The US rate was 12.1 for every 100,000, Brazil’s was 15.8 and Mexico’s was 23.5, while Argentina was at 24.6.

The figures are revealed in the WHO World Health Statistics 2017 report, published on Wednesday, which says substantially reducing the number of deaths globally from air pollution is a key target.

The report reveals outdoor air pollution caused an estimated 3 million deaths worldwide, most of these in low- and middle-income countries.

Wealthy European nations had high levels of air pollution from fine particulate matter. The UK had an average of 12.4 micrograms of fine particulate pollutants (PM 2.5) for each cubic metre of air, which includes pollution from traffic, industry, oil and wood burning and power plants in urban areas. This is higher than the pollutant levels of 5.9 in Sweden, 9.9 in Spain and 12.6 in France. Germany had higher levels of particulate pollution than the UK at 14.4 and Poland’s was 25.4.

Dr Penny Woods, chief executive of the British Lung Foundation, said the report confirmed that deaths from air pollution were higher in the UK than many other comparable countries.

She said: “It is deeply tragic that around 3 million lives are cut short worldwide because the air we breathe is dirty and polluted. In the UK, air pollution is a public health crisis hitting our most vulnerable the hardest – our children, people with a lung condition and the elderly.

“Yet, we are in the fortunate position of having the technology and resources to fix this problem. It’s time to use what we have to sort this problem out as a matter of urgency and clean up our filthy, poisonous air. The next government needs to bring in a new Clean Air Act to protect the nation’s lung health.”

The worst countries for toxic air included India, where 133.7 deaths for every 100,000 people are attributed to air pollution, and Myanmar, where the rate was 230.6 deaths.

WHO said: “Outdoor air pollution is a major environmental health problem affecting everyone in developed and developing countries alike.

“Some 72% of outdoor air pollution-related premature deaths were due to ischaemic heart disease and strokes, while 14% of deaths were due to chronic obstructive pulmonary disease or acute lower respiratory infections, and 14% of deaths were due to lung cancer.”

The World Health Organisation said it was up to national and international policymakers to tackle the toxic air crisis

“Most sources of outdoor air pollution are well beyond the control of individuals and demand action by cities, as well as national and international policymakers in sectors like transport, energy, waste management, buildings and agriculture,” the WHO said recently.

Indian court allows 10-year-old rape victim to have an abortion

A 10-year-old girl who was raped will be allowed to have an abortion even though she has crossed the 20-week limit for terminations in India, police in the country said on Wednesday.

The child has said she was repeatedly raped by her stepfather, who has since been arrested.

Her case only came to light last week, by which time she had crossed the 20-week legal limit after which terminations are only allowed where there is a danger to the life of the mother or the baby.

“The court had asked the medical board to take a call and doctors have decided to go ahead with the abortion,” Garima Devi, the police investigation officer assigned to the case, told AFP.

“The board has not said when they are planning it (abortion) but it will be any time soon.”

In recent months India’s top court has received a number of petitions from women – including rape survivors and trafficking victims – seeking abortions where pregnancies had gone beyond 20 weeks.

Activists say the restriction should be extended to 24 weeks as victims of rape are often late to report their pregnancies.

The Indian Express said the victim’s mother wanted the accused to be set free as he had apologised and that she had other children to take care of.

“The girl’s life is destroyed but what will happen to my other children? I need to think about their future too,” the daily quoted the mother as saying from a hospital in Rohtak, a district in northern Haryana state.

India has a gruesome record on rape, with the capital New Delhi alone registering 2,199 rape cases in 2015 – an average of six a day.

A UN Committee on the Rights of the Child in 2014 expressed alarm over the widespread sexual abuse of children and said one in three rape victims in India was a minor.

Supporting LGBTI pupils: ‘It’s important a school is ready for anyone’

It was not long ago that LGBT pupils at the Priory School in Hitchen, Hertfordshire, hid behind a mask of silence. Fellow students used the word “gay” to describe something that was rubbish. Faced with homophobic language, they felt unable to come out in the classroom and kept their true identities secret.

Three years later, dozens of students have come out thanks to a “massive culture shift” in school. Today, diversity and inclusion are celebrated across all aspects of school life: from the setting up of an LGBT drop-in group and appointment of an LGBT student champion, to changes in the curriculum and the building of gender-neutral toilets and changing rooms. Indeed, the school has established such a reputation for equality it is attracting transgender pupils from neighbouring areas.

Priory now has a resident counsellor and has forged close links with local child and adolescent mental health services. Sixteen staff have also been trained in mental health first aid.

Assistant head Katie Southall has led the transformation. Responsible for student wellbeing, Southall realised that more needed to be done to promote equality and diversity. Surveys of young people who identify as LGBT revealed that many are at high risk of mental health problems.

The 2016 Youth Chances survey, conducted by the charity Metro in collaboration with the University of Greenwich, found that out of the 6,414 respondents aged 16-25 who took part in the survey and identified themselves as LGBT, some 44% said they had considered suicide.

Southall says: “We realised from an annual survey on student wellbeing that lots of students identified as gay or LGBT, but didn’t want to be open about it. We are now in a position where pupils are openly transgender, gay, bi, lesbian or gender questioning. For those who are transgender we have procedures in place for name changes and work together with the young person. That can mean getting people who have transitioned to come in and talk to young people.”

LGBT role models have also visited the school, including actor Sir Ian McKellen, co-founder of LGBT charity Stonewall, who spoke to 35 student members of the weekly LGBT drop-in group. “One sixth-former who is gay said he wished the school had been as open when he was in key stage 3,” Southall says.

Meanwhile Arbury primary school in Cambridge is working hard to promote diversity and has become a beacon of good practice. It has adopted a range of initiatives to stamp out gender stereotypes across the school, from abolishing pink- and blue-coloured name badges for reception children, to having a non-gendered school uniform.

Children are taught to respect difference from the start in reception: through picture books showing different types of families, and talks during circle time highlighting the school’s golden rules. Displays of materials from Stonewall with the slogan: “Different families, same love” are posted around the school, which also celebrates LGBT history month.

Staff are trained to understand how stereotyped views of how boys or girls should behave can prevent them from reaching their potential. Senior teacher Kathy Whiting says the school advises other schools on creating a trans-inclusive environment, including training on the use of inclusive language.

Headteacher Ben Tull says: “It is really important that a school is ready for anyone who walks in. For children at primary level, the more we can do to non-stereotype them the better. We steer away from the binary model.”